Our Decision Making Process and Helpful Resources
Jack is four weeks into a wilderness treatment program. We are starting to think about whether he comes home after graduation and we continue the with local therapists and tutors or do we send him to a therapeutic boarding school.
I have shared our family’s story in previous posts. The highlights … I have two boys, Ben is 13 and Jack is 11. We started down the disability and mental illness paths when Ben was 3 years-old. Jack was our “typical” child. Two years ago, Ben went to a residential treatment center. Jack experienced a calm and stable home for the first time. Jack was thriving, or so we thought. Ben came home and Jack’s world fell apart.
Jack has showed signs of anxiety and ADHD since a very young age. He always has to be right, win, and know it all. He is smart, precocious, and until recently, excelled at whatever he touched.
Over a six month period Jack withdrew, become obsessed with/addicted to Minecraft, stopped going to school, refused to go to therapy, and lied, stole, and manipulated. After an unsuccessful psychiatric hospitalization, Jack continued to punch, kick, and choke us in an effort to get on the computer. We made the decision to send him to a wilderness treatment program.
Ben had his first neuropsychiatric evaluation. He was diagnosed with ADHD, general anxiety, and opposition defiant disorder (ODD). All of which we agree with. He received a superior rating across all academic measures and high average on most of the executive functional scales. The psychologist is recommending a jr. therapeutic boarding school.
We receive detailed feedback from Jack’s therapist at the wilderness program weekly. She is on the fence with whether to continue the work at home or send Jack to a therapeutic boarding school.
This is the first of a three posts documenting our decision making process. This post focuses on how I organize my thoughts and come up with a game plan. The second post will walk through in detail how we evaluate all options. Drum roll … the third post revels our decision and transition plan.
Step One: Organizing and Planning
I don’t know about you; however, when I get to this critical juncture I am exhausted and emotionally drained. I have to fight the urge to frantically research schools on the internet. Instead, I force myself to take an hour or so to organize my random thoughts. This includes taking inventory of what we know, reflecting on our current reality, and identifying what else we need to know about Jack to help us make this big decision. Here goes …
Initial Required Pieces to Support Jack
To find or build a program that:
- Teaches Jack coping strategies to manage ADHD and anxiety
- Builds in academic supports/accommodations
- Offers a rich and experiential academic program with a small class size
- Helps Jack with emotional regulation and frustration/anger tolerance
- Helps Jack process feelings about being adopted and living with a special needs brother.
Initial Possible Scenarios
For Jack we currently have two scenarios on the table.
Scenario 1: Jack comes home and participates in daily tutoring to get caught up with school work. He participates in individual and family therapy. He resumes one extra curricular activity. He goes back to his current private school or attends the public school.
Scenario 2: Jack goes to a therapeutic boarding school for approximately a year with focused daily therapy and a strong academic program. We talk weekly and visit every month or so.
Our Current Reality
- Jack’s brother, Ben, is doing well; however, he still requires a great deal of energy, patience, and compromises
- We live in New Hampshire where therapeutic resources are limited
- My husband travels Monday through Thursday every week
- The boys are getting bigger than me
- Jack attends a very nurturing private school and has good friends
- I have a good support network
- We do not have afternoon/early evening in home support for Ben (which will be needed if Jack comes home and has after school therapy appointments).
What We Know About Jack
- Three diagnosis’s – ADHD, anxiety, and ODD
- Jack will need to manage ADHD and anxiety for life with therapy and medication
- With intense therapy, the ODD symptoms should diminish greatly
- Jack is very smart and skilled at manipulating
- Jack tends to “quit” when things get tough and does not take accountability
- He is very dependent on technology and games; borderline addictive.
What We Don’t Know About Jack And Need To Understand
- What Jack will look like on ADHD medication.
- Jack’s therapist shared that he is starting to make some progress; what is the motivation for the change in behavior – internally driven versus compliance due to the challenging environment
- What types of therapy is Jack responding well too
- What support and services we will receive from our school district (Jack does not attend our public school)
- Jack’s thoughts on the two scenarios.
- Work with the wilderness treatment program and psychiatrist to introduce an ADHD medication
- Meet with our district’s special education director to share objectively our current situation and explore available supports and services; gauge potential financial support for out-of-district placement
Important: My goal for this meeting is strictly to gather information and gauge level of support. Once we have a better sense of which direction we are heading, I will schedule a follow up meeting.
- Work with our therapist to facilitate a conversation with Jack; what does he see as the pros and cons to each scenario (we value his input; he is not the decision maker)
- Talk with our therapist to better understand the motivation behind Jack’s recent progress and the types of therapies he response well too
- Identify local resources and compile a list of potential therapeutic boarding schools
- Begin exploring after school support for Ben if Jack comes home.
We have been down this path before with Ben. This time around we are not planning on using an education consultant. With that being said, education consultants can add great value in navigating this stressful process.
I will close this post with some resources I find very helpful in this process.
Preview … Step Two
The next post will walk through the nitty gritty of evaluating programs and narrowing down options.